True Out-of-Pocket Costs (TrOOP)
TrOOP is the running total of out-of-pocket spending that counts toward your Part D coverage limits. It includes what you and certain others pay for covered drugs and determines when you reach the annual out-of-pocket cap.
Understanding True Out-of-Pocket Costs (TrOOP)
TrOOP (True Out-of-Pocket costs) is the running tally Medicare uses to track your progress through the Part D prescription drug benefit phases. It counts what you and certain others pay for covered drugs, and it determines when you reach the catastrophic phase and the annual out-of-pocket cap.
For beneficiaries, understanding TrOOP matters because not every dollar counts. Your deductible, copays, coinsurance, and payments from programs like Extra Help and most charities count toward TrOOP, but your monthly premium and amounts paid by your plan generally do not. Reaching the TrOOP threshold is what unlocks the lowest drug costs for the rest of the year.
For example, in 2025, once your TrOOP reaches the $2,000 annual out-of-pocket cap, you pay $0 for covered Part D drugs for the remainder of the year — a major change from the old coverage gap.
Have questions about TrOOP and your drug costs? Get a free Medicare review and we will show you how the new $2,000 cap affects you.
Related Terms
Part D
Medicare Part D is prescription drug coverage. You can get it through a standalone Prescription Drug Plan (PDP) or through a Medicare Advantage plan that includes drug coverage.
Donut Hole
The donut hole (coverage gap) is a temporary limit on what the drug plan will cover. Once you reach this limit, you pay a higher percentage of drug costs until you reach catastrophic coverage.
Maximum Out-of-Pocket (MOOP)
The maximum out-of-pocket is the most you pay in a year for covered services. Once you reach this limit, your plan pays 100% of covered costs for the rest of the year.
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